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Month: April 2014

Recent announcements by two government agencies, the HMRC and the Health and Social Care Information Centre (HSCIC), regarding the sale of information has thrown a spotlight upon government information and the attendant debates of privacy verses exploitation. What is the ownership of information collected by the state? Held in trust for the citizen, or seen as assets like 3/4G mobile phone licences to be sold by government to the highest bidder? Or should all government data be treated as open data that is made freely available to all?

Government information is gathered in a number of ways, by legal requirement and from its nodal position within networks. Data, then, may not be provided willingly. The willing provision of information is governed by the concepts of notice and consent. Consent is given by the citizen having the right to know why information is collected and for what purpose, and is supported by the right to withhold agreement. Without this procedural fairness, the use, and sale, of data can fatally undermine trust in the data collector.

The sale of public data is not a new phenomenon brought about by the clamour for “Big Data” or the development of database services like Hadoop; indeed the trend for the sale of public data may be seen with the sale of the edited electoral register under the terms laid down by the Representation of the People Act 2000. The sale of personal address data, for those who have not opted out (and the sale of all data to Credit Reference Agencies), is now well established and has fuelled the direct marketing industry, allowing large numbers of companies to purchase and exploit information. Consent is assumed with a default opt-in, the citizen having to actively request that their information is not sold. The principle established then is that data accumulated by the state is an asset of the state, and may be disposed of as such.

Turning to the recent examples of the proposal to sell some HMRC tax data, described by Conservative MP David Davies as “borderline insane” and the currently suspended care.data plan under which the HSCIC will make data available to a range of organisations, or customers in the language used by the HSCIC, meeting the wide ranging description of “academics and universities, healthcare commissioners and providers, third sector organisations, information intermediaries and commercial organisations including life science companies”. These groups can purchase, and a detailed cost schedule is provided for, what is described as “De-identified data for limited disclosure or access – data that has been through a process of pseudonymisation, however there remains a risk of individuals being identified”.

The question turns to who owns personal data; that is the data likely to infringe privacy, and is this still considered to be a state asset? At first glance medical, social care and financial information would appear to be central to the definition of the private realm, especially when combined with name and address. However does this still hold when the information is pseudonymised? How secure is a pseudonym, could the data still make the individual identifiable; for example how many individuals with Crohn’s disease and one child live within a given postcode? The exact nature of the information and the ability to cross-correlate data can lead to individual identification.

In all of these examples, it can be seen that government treats the information at its disposal as an asset which it owns outright and can sell within the bounds of data protection legislation, if it so chooses. In taking this step, the government assumes the best use of this data is to sell it to a small number of selected users, rather than releasing the information wholesale.

The voluntary sharing of what would otherwise be considered sensitive or personal data has been commonplace since the introduction of store “loyalty” cards. These cards act as a method of exchange for personal details, for example basic demographic information (including name and address) together with a detailed transaction history allowing the store to determine the spending habits of the individual and of a cohort of similar individuals; (Rust, et al., 2010). People are happy to voluntarily part with some personal data as part of a transparent process, where there is an obvious reward and where they may consider themselves to be in control.

The Government approach is somewhat different; it appears to take the view that information its asset to be disposed of as it sees appropriate, in what is perceived as the national best interest. This is a case of acting without procedural fairness, which as can be seen from press coverage, results in a fatal loss of trust.

So, where does this leave the question of the sale of information? The issue that government must address is the conditions and terms for the release of data; and it must take the public with it on this journey. A keystone in this debate, government must determine whether it sees public information as a saleable asset or as a national resource. Transparency regarding the state’s attitude to information that it holds is crucial to popular support for either open data initiatives or the treatment of information as an asset. This transparency must include an understanding of the value of the information.

Tom Barrance is a part time Doctoral Researcher looking at Gov 2.0 in UK Local Government, and a full time Business Analyst/Project Manager at the London Borough of Hackney. He has worked in the public sector for the past 13 years, at a number of different local councils in a range of roles in Economic Development, business change and delivering ICT solutions.

Two EU countries this May will hold local elections that coincide with their European parliamentary elections: Greece and ourselves. On Sunday 25 May Greeks vote in the second, ‘run-off’ round of elections to all their 13 regions and 325 municipalities. England, though nearly five times as populous as Greece, also has 325 lower-tier and unitary authorities. We, however, will elect mostly only fractions of fewer than half of our councils, yet still it takes seven lines of a table to summarise the 161 authorities whose voters on Thursday 22 May will probably have both a local and Euro vote. We bemoan our disappointing local turnouts, but we don’t make the system exactly voter-friendly.

Inevitably, the Euro elections will dominate the campaign, and the all-out London borough elections will dominate the local results. In this preview too – though less so in the longer INLOGOV Briefing Paper – all-out elections are accorded priority.

May 2010, when most of this year’s retiring councillors were elected, was Labour’s second worst parliamentary election performance in 80 years. Given a different context, though, its local and particularly its London election performance would have been justifiably celebrated – three boroughs won directly from the Conservatives (Ealing, Enfield and Harrow), seven more from No Overall Control (NOC), and more London seats than the Tories for the first time since 1998.

There’s no mystery about the national-local discrepancy – just two big reasons: the four-year electoral cycle and the General Election-boosted turnout. The seats up in 2010 were those contested in 2006, when Labour’s estimated 26% of the national vote barely topped the Lib Dems’ 25% and was way adrift of the Conservatives’ 39%. By 2010 that 13% national vote gap had halved, bringing big Labour gains in both votes and councils – thanks partly also to hugely increased turnouts of over 60%, benefiting the large parties, especially Labour, at the expense of minor ones.

Of nearly 1,600 minor party and independent candidates in London, just 23 were elected: 2 Greens, down from 12 in 2006 (Camden, Lewisham); 1 Respect, down from 15 (Tower Hamlets – now 2); no BNP, and no UKIP – though the party has since reached double figures, mainly through Tory defections. This year turnouts will be down again, and minor party representation – including, but not only, that of UKIP – equally certainly up.

London is not a UKIP priority, and its best prospects may be in those boroughs where it already has defectors – Hounslow, Merton and Havering (from the Conservatives), Barking & Dagenham (from Labour). But UKIP influence – countrywide but particularly in London, where electors have potentially three local votes – will also be more subtly felt through vote-splitting, helping Labour to gain control, or possibly the Lib Dems to retain it, where they might not otherwise have done so.

With its long-term opinion poll lead, though, it is again Labour that will be expecting to win councils as well as seats. Back in early January, Sadiq Khan, Shadow Minister for London, announced the party’s ‘suburban mindset’ strategy, and its five Outer London ‘battleground boroughs’ – Conservative-controlled Barnet and Croydon, and the currently hung Harrow, Merton and Redbridge.

The latter are the proverbial low-hanging fruit. In HARROW Labour actually won a majority in 2010, but then, as described in a blog at the time, lost it through splits and defections, handing control to the current Conservative minority administration. In MERTON it took minority control, strengthened it through Conservative defections to UKIP, and achieved a good result in last summer’s Colliers Green by-election. In REDBRIDGE the Conservatives and Lib Dems signed a partnership agreement just as their leaders were doing the same at Westminster. In all three boroughs Labour will be aiming for majority control, in Redbridge for the first time ever.

In CROYDON the Conservatives narrowly retained a 4-seat majority through an electoral system rewarding nearly 19% of Lib Dem voters with no councillors at all. Here too a modest swing would give Labour an equally workable majority, and more than justify the party’s decision to employ a full-time agent.

BARNET, though, seems an altogether tougher proposition. Numerous issues have incensed residents – from the ‘One Barnet’ mass privatisation of council services, through the closures of libraries and children’s centres and the scrapping of sheltered housing wardens, to the ever-contentious increased parking charges. But Labour has never won more seats than the Tories, and to do so would require a nearly 10% swing plus the Lib Dems clinging on to their three very marginal Childs Hill seats.

Labour’s last listed London target is the TOWER HAMLETS mayoralty, held by the controversial Independent and Labour expellee, Luftur Rahman. Opponents have accused him of everything, from dubiously selling off and granting planning permission for the hotel conversion of the listed Poplar Town Hall to trying to buy his own re-election, but little of the mud really seems to stick and it may, if anything, boost his support. Panorama recently had a go, following which Eric Pickles sent in his inspectors – though not to report back until well after the May elections.

The other four mayoral contests all involve incumbents who were elected in 2002 and are now seeking their fourth consecutive terms: Jules Pipe (Hackney), Steve Bullock (Lewisham) and Robin Wales (Newham), all Labour, plus the Lib Dem Dorothy Thornhill in WATFORD. All four have their policy initiatives and successes, but only Thornhill can claim in addition to have totally recast the politics of her town and council. Watford in 2002 was an apparently permanently Labour-run town. Yet its voters chose as their mayor a Lib Dem councillor and assistant head teacher, whose party coattails have since transformed the council chamber to the extent that two-thirds of members today are Lib Dems.

Returning to London, with the Lib Dems’ local election performance having collapsed almost as grimly as its national poll ratings, the party’s two majority-controlled London boroughs are bound to be under scrutiny. SUTTON they’ve held since 1990 and, although they lost one councillor to Labour, arithmetically at least they look safe for another term. In KINGSTON UPON THAMES, though, with one councillor resigning to sit as an Independent, plus a lost by-election following their disgraced leader’s imprisonment, their 2010 six-seat majority now hangs on a single seat – and on the hope that UKIP may take votes from the Conservatives in the right places.

The other all-out elections are those caused by boundary reviews, two resulting in slightly enlarged unitary councils and two in smaller district councils. MILTON KEYNES has been run in the recent past by all three major parties, and since 2011 by a minority Conservative administration. Labour will be aiming to become at least the largest party on the new, enlarged council. SLOUGH, it is totally safe to say, will continue to be Labour. In THREE RIVERS the Lib Dems will seek to maintain the majority control they’ve held since 1999; and in HART Labour will be wistfully recalling when it last won even a ward – in 1976.

Of the 36 metropolitan boroughs, Labour already controls 29 and so has little need of a target list here. Of the two Conservative councils, TRAFFORD looked the more vulnerable even before the recent shock resignation of Matt Colledge as both council leader and councillor. Having reduced the Tories’ majority to 3 in a recent by-election, Labour will hope to win its own for the first time since 2003. The SOLIHULL Conservatives look securer, partly because their principal challengers, the Lib Dems (now 9), have been defecting to the Greens (now 7), who will be seeking to supplant them as the official opposition.

The West Yorkshire trio of Bradford, Calderdale and Kirklees have all been hung since at least 2000, but this could be about to change. In BRADFORD Labour’s 2012 hopes of turning its minority control into a majority were thwarted by the coattails effect of George Galloway’s parliamentary by-election victory for Respect. The coattail councillors all resigned last October to become Independents, and Labour should make it this time.

KIRKLEES and CALDERDALE travel in parallel. Five years ago, both boroughs were run by Conservative minorities, which were replaced by Labour-Lib Dem coalitions, which were succeeded in turn by Labour minority administrations. In both boroughs all three main parties have groups numbering at least double figures – a measure of the difficulty any one party has in trying to win an overall majority. Arithmetically Kirklees looks the more attainable for Labour, but the party would probably have to take seats from the Conservatives, Lib Dems and Greens. In Calderdale, in the wards being defended that require swings of less than 10% to change hands, Labour is unlikely to be the chief beneficiary, having finished in second place in 2010 in just three to the Conservatives’ ten.

In STOCKPORT, the Lib Dems now have only minority control of their metropolitan flagship, and are defending 12 of their 29 seats. Labour is the leading opposition, but, having finished second in only two of them in 2010, its gains may be limited. Already the largest party in WALSALL, its chances should be better. If it won the same wards as in 2012, but without this time losing a couple of others to Independents, the party could gain majority control for the first time this century.

Chris Game is a Visiting Lecturer at INLOGOV interested in the politics of local government; local elections, electoral reform and other electoral behaviour; party politics; political leadership and management; member-officer relations; central-local relations; use of consumer and opinion research in local government; the modernisation agenda and the implementation of executive local government.

Some social phenomena are exceptionally tricky to measure: the black economy, white-collar crime, illegal immigration. So when someone claims to have done so, no matter how flaky their findings, they attract huge, and largely uncritical, media attention. Like last week’s excitement about the scale of NHS fraud.

The catalyst was a Panorama programme – The Great NHS Robbery – that needed some pre-transmission headlines. The programme consisted mainly of specific cases of GPs, dentists, pharmacists, private contractors and suppliers who’d been found guilty of defrauding the NHS. It alleged that the Government’s official NHS fraud figure of £229 million p.a. is a huge under-count or under-estimate, and suggested that, having cut the staffing and budgets of NHS Protect and other fraud investigators, the Government was turning a proverbial blind eye to the scale of the problem, especially by comparison with the increased resources it allocated to the detection of the much smaller quantum of benefit fraud.

Old cases and political sniping, however, don’t make major headlines. What Panorama needed were some seriously big and scary figures, and fortunately there were some to hand – just down the M3 at the University of Portsmouth’s Centre for Counter Fraud Studies (CCFS). By happy coincidence, the CCFS was about to co-publish, on the very same day as the first showing of The Great NHS Robbery, a report analysing, as the programme put it, “the most rigorous data on health care fraud in the world”, and containing some “staggering” findings for the NHS.

The BBC had its headlines – “NHS fraud and error costing the UK £7 billion a year” – and Panorama had its audience. Other contemporaneous media headlines were all apparently taken either from the BBC’s plug story or the programme itself. Some were fractionally more cautious, like The Guardian’s “NHS fraud could be as high as £5 billion a year, says former health service official”; others less, like the Nursing Times’ “Fraud costs NHS £7 billion – enough to pay for 250,000 nurses”.

None of the authors, it seemed, went to the CCFS report to check how the loss figures were arrived at and what they represented – possibly imagining that a global report on such a complex and technical topic, representing the product of several years’ research, would be vast, probably undownloadable, and incomprehensible to the average reader.

Interestingly, though, it’s none of these things. The Financial Cost of Healthcare Fraud 2014: What data from around the world shows runs to just 16 pages, including the two covers. The rest comprises: Contents, Foreword, three prefaces, three pages about the authors and publishers, a full-page picture, a blank page … and a 4½-page ‘report’. There are no “data from around the world”, so, even with the glossy pictures, you could, if you wished, download it in about a second.

However, to save you having to plough through all 4½ pages yourselves, let me take you through the methodology step by step.

1. Do a literature review of the 92 studies of healthcare fraud and error losses that you’re able to find that have been undertaken since 1997 – not ‘globally’, but in languages you can understand: the UK, US, France, Belgium, the Netherlands and New Zealand;

2. Don’t worry about the studies being in numerous completely different areas of health care, but average out the quoted financial loss figures in all 92 studies and cite that average with real authoritative precision – i.e. not 7%, but 6.99% – because, remember, these have to look like “the most rigorous data on health care fraud in the world”;

3. Globalise your ‘research’ by finding a figure for global healthcare expenditure for some recent year (no, not ‘global’ as in your six countries, but really global) – say, $6.97 trillion for 2011 (or £4.48 trillion) – and again don’t worry about whether they’re US or International $$ or what the figure actually represents, for this is one of those footnote- and reference-free reports;

4. Divide (3) by (2), and again state the sum with great precision: that this shows that £313 billion is being lost by the world’s healthcare services each year – or 25% more than when you last did the sum in 2008;

5. Guess – because you’ve apparently no evidence one way or the other – that the financial integrity of the NHS is probably about average for the six countries you’ve studied, and assert that it is therefore losing 7% of expenditure each year – or £7 billion out of its roughly £100 billion total – in ‘fraud and error’, making sure, of course, that you emphasise the fraud bit.

6. Add a little diagram, as shown below with the addition of my clarification of where the UK figure comes from.

I must confess at this point to having misled you a little. I mentioned that the report contains no “data from around the world”, and indeed there are no figures for the UK or any other individual country. The £7 billion came in the Panorama programme, from one of the report’s two principal authors, Jim Gee. Gee is the former health service official referred to The Guardian’s headline: former CEO of the NHS Counter Fraud Service and now Director of Counter Fraud Services at BDO LLP – not, sadly, the British Darts Organisation, but Binder, Dijker, Otte and Co., an accountancy firm specialising in anti-fraud services – and Chair of the CCFS at the University of Portsmouth. Gee left it to the programme’s presenter to add that “he puts more than £5 billion of that £7 billion down to fraud, rather than financial error” – which explains the other part of The Guardian’s headline.

Though certainly not on the same scale as its undercover filming of LSE students in North Korea, Panorama’s decision to rest the central argument of this programme on such flaky statistics, produced at least in part to further the interests of a self-promoting business services company, seems to me another clear editorial misjudgement. Certainly it irritated me when I pieced together the above account and realised that in effect I’d been conned.

Much more importantly, though, it must in anything other than the short term undermine, rather than substantiate, the key points the programme was seeking to make: that the way the Department of Health currently measures and estimates NHS fraud is grossly inadequate and damagingly misleading; that governments, and this Government in particular, see it in their interests to under-record the scale of fraud (and financial error, for that matter); and that more, rather than less, funding should be being invested in fraud detection and inspection services.

The sad truth is that Panorama seized on CCFS/BDO’s £5 to £7 billion because there was nothing better or more accurate available. Jim Gee’s ‘methodology’ suggests to me that he’s probably underestimating global healthcare financial losses and overestimating those of the NHS, but neither I nor the Government have any way of officially demonstrating it. Nor is there any likelihood of the Government, since it is substantially in denial, embarking on a programme to reduce the losses by up to the 40% within 12 months that Gee, wearing his BDO hat, considers feasible. I doubt if many others agree, but, to adapt the proverb: in the land of the dataless, the one-figure man is king.

Chris Game is a Visiting Lecturer at INLOGOV interested in the politics of local government; local elections, electoral reform and other electoral behaviour; party politics; political leadership and management; member-officer relations; central-local relations; use of consumer and opinion research in local government; the modernisation agenda and the implementation of executive local government.